The prevalence of obesity and metabolic syndrome (MetS) has increased over the past several decades and is expected to continue to increase. Although the individual components of MetS have previously been associated with chronic kidney disease (CKD) and end-stage renal disease (ESRD), until recently there were few data on the relationship between MetS itself and incident CKD and ESRD. A recent meta-analysis demonstrated an association between MetS and CKD. When pooling 10 prospective cohort studies, MetS was associated with an increased odds ratio for an estimated glomerular filtration rate (eGFR) less than 60 mL/ min per 1.73 m 2 (OR, 1.55; 95% CI, 1.34-1.80). Additionally, published data suggest an association between MetS and albuminuria. Evidence suggests that lifestyle modifications such as weight reduction, reduced dietary fat intake and cholesterol, and pharmacologic treatments may reduce the burden of MetS and thus the risk for CKD, albuminuria, and ESRD. © Springer Science+Business Media, LLC 2012.